title: Multiple focal nodular hyperplasias induced by oxaliplatin-based chemotherapy.
abstract: Focal nodular hyperplasia (FNH) is a benign condition that affects normal liver with low prevalence. Recently, the extensive use of oxaliplatin to treat patients with colorectal cancer has been reported to be associated with the development of different liver injuries, as well as focal liver lesions. The present work describes two patients with multiple bilateral focal liver lesions misdiagnosed as colorectal liver metastases, and treated with liver resection. The first patient had up to 15 small bilateral focal liver lesions, with magnetic resonance imaging consistent with colorectal liver metastases (CLM), and fluorodeoxyglucose (FDG)-positron emission tomography (PET) negative. The second patient had up to 5 small focal liver lesions, with computed tomography consistent with CLM, and FDG-PET negative. They had parenchyma sparing liver surgery, with uneventful postoperative course. At the histology the diagnosis was multiple FNHs. The risks of oxaliplatin-based chemotherapy regimens in development of liver injuries, such as FNH, should not be further denied. The value of the modern multidisciplinary management of patients with colorectal cancer relies also on the precise estimation of the risk/benefit for each patient.
authors.affiliation: Matteo Donadon, Guido Torzilli, Liver Surgery Unit, Department of General Surgery, University of Milan, Humanitas Clinical and Research Center, 20089 Rozzano, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Donadon
authors.forename: Luca
authors.initials: L
authors.lastname: Di Tommaso
authors.forename: Massimo
authors.initials: M
authors.lastname: Roncalli
authors.forename: Guido
authors.initials: G
authors.lastname: Torzilli
keywords: Colorectal cancer; Colorectal liver metastasis; Focal nodular hyperplasia; Oxaliplatin; Systemic chemotherapy